Obsessive compulsive disorder - OCD treatment and therapy from NOCD

What Is Just Right (Perfectionism) OCD?

By Nicholas Farrell, Ph.D

Oct 23, 20238 minute read

Reviewed byPatrick McGrath, PhD

There’s no denying that people have a lot of ideas—and misconceptions—about obsessive-compulsive disorder (OCD). Many people who are unfamiliar with the mental health condition imagine that sufferers wash their hands hundreds of times a day, fearing germs or contamination. Or they believe that OCD translates into a desire to have everything “just right”—whether that’s placing things in the “exact right” position or rearranging some other part of their environment or life exactly as they want it to be.

While there are many subtypes of OCD and many do not fit neatly into these stereotypes, there is such a thing as “Just Right OCD” which is also called Perfectionism OCD. Still, there’s a lot more to understand about this manifestation of OCD—why it happens, what it looks like, and how to get help.

It’s harder to identify and more harmful than many people think, but as a specialist in OCD treatment, I can assure you: if you think you might be struggling with perfectionism OCD, you are not alone, and your symptoms aren’t “just the way it is.” Let’s take a look at how they can actually impact your life, and what you can do to get better.

Perfectionism vs. OCD: Is there a Difference?

There are lots of words that are thrown around to describe someone with a preference for having things “just right”: Type-A personality and perfectionist, for example. But there’s a difference between OCD and a personality trait. Most important, OCD is a mental illness, not a quirk or a personality trait. 

It’s true that people with perfectionism can sometimes wish they would be easier on themselves. But perfectionistic people are often not looking to change their perfectionistic ways, because they bring a sense of reward. By contrast, people with OCD often feel tormented by their perfectionist behavior. In the words of my colleague Taylor Newendorp, MA, LCPC, and author of The Perfectionism Workbook: “They may want to stop but they simply can’t.

Just Right OCD/Perfectionism OCD Symptoms

Just Right or Perfectionism OCD is a subtype of OCD that is characterized by ongoing intrusive thoughts and compulsive behaviors around organization, perfection and making things feel “just right.” People with Just Right OCD experience frequent intrusive thoughts around organization and symmetry, and they perform certain actions until they feel it is complete or “perfect” (e.g., switching a light switch on and off seven times before leaving a room). The underlying anxiety is characterized by an unsettled feeling that something is just not right.

People who have Just Right OCD may fixate on parts of their body, like making sure their fingernails are the exact same length, their hair is perfectly arranged, or their makeup is applied perfectly and symmetrically. They may fixate on a certain structural asymmetry, like their nostrils, and attempt to perfect it by breathing in a certain way or spend time researching plastic surgery options that could correct it. Another common obsession for this OCD subtype is being fixated on physical sensations. So if someone touches your right arm by mistake, you must touch your left arm in the same place to “even it out.” This may also look like not avoiding stepping on cracks on the sidewalk, or making sure your steps are even.

Other people with Just Right OCD may experience doubting thoughts about their written or verbal communication. A person may fixate on certain things they’ve said, or the specific words they are using while talking, and correct themselves mid-speech if the word isn’t perfectly representing what they wanted to express. A person may feel each sentence must be exactly the same length to be perfect and rewrite them until they are. Or they may reread texts or emails over and over before and after they are sent. They may struggle to make the shape of each word symmetrical and keep on finding new ones until they are. 

The compulsions people with this subtype experience are usually centered around trying to fix what they perceive to be imperfect or incomplete. These compulsions can be incredibly time-consuming and can often cause people with Just Right OCD to run late to scheduled commitments in their life. It can also be socially isolating for people when their OCD forces them to engage in physical compulsions in the presence of others (e.g., switching a light switch seven times in front of a friend. People with this OCD subtype may find themselves avoiding situations entirely so that they don’t have to deal with the time and stress required to make things just right.

It’s common for people to see their symptoms of Perfectionism OCD as a part of their personality, or “just the way it is.” In reality, these symptoms can demand a tremendous amount of mental energy and cause you to lose hours of your day to compulsions. I want to emphasize that if you suspect your symptoms may be impacting your life, it’s important to talk to a professional with experience and training in OCD in order to decide if treatment may help.

Common Obsessions in Just Right OCD

  • If I don’t fix this picture frame, something bad will happen. 
  • The pillows don’t look just right, and I can’t handle that—I must fix them. 
  • When I do my hair, it has to be perfectly even. 
  • I need to make sure this text message is phrased just right and gets my message across perfectly, otherwise, this person will judge me.
  • Every time I walk outside, I have to make sure I’m stepping on an even number of sidewalk cracks.
  • If someone accidentally touches my left shoulder, I have to touch my right shoulder to make it even. I won’t be able to concentrate until I do.  
  • When I’m typing, I need to make sure my fingertips on both hands are touching symmetrical keys. 
  • I can’t concentrate on my assignment until the word document is properly aligned. 
  • I’m not sure if I measured out the right amount of coffee beans for my machine, so I need to do it again. I have to make sure it’s perfect. 

Common Compulsions in Just Right OCD 

Fixing behaviors to make things just right: This is the most common compulsion for this subtype of OCD. When something appears out of order or incomplete, a person with Just Right OCD will try to make it right. This could mean measuring out their coffee as many times as needed until they are sure it’s the perfect amount. Or spending hours rewriting a brief email until it is perfect. The compulsion to fix things could be ritualized, like needing to turn a light switch on and off 5 times before leaving each room. It could look like repeatedly putting a shirt on until it feels right. These compulsions can range from quick activities that take a few seconds but can demand hours of a person’s day.

Avoidance: Because people with Just Right OCD experience high levels of anxiety when things appear to be incomplete, they may avoid certain situations or places where they know their OCD will likely be triggered. For example, if someone needs to make sure each handwritten letter is exactly aligned, and this process takes hours, they may find themselves avoiding writing by hand. If sending a text message consumes hours of a person’s day because they have to read it repeatedly, they may decide it’s best to stop texting. 

Reassurance-seeking: In certain situations, people with Just Right OCD may turn to friends or family for reassurance. They may ask, “Does this picture frame look straight to you?” They may repeatedly ask friends for a second opinion on an email to make sure it’s coming across as they intend, or check that the person they spoke to understood what they meant to say exactly as they intended it.

What’s the Most Effective Therapy for Just Right OCD? 

The best course of treatment for Just Right OCD, like all types of OCD, is Exposure and Response Prevention (ERP) therapy. ERP is considered the gold standard for OCD treatment and is backed by decades of rigorous scientific research.

As part of ERP therapy, you’ll work with a specialty-trained ERP therapist to slowly put yourself into situations that bring on your obsessions. The idea behind ERP therapy is that exposure to your fears is the most effective way to treat OCD. When you continually reach out for the compulsions, it only strengthens your need to engage in them. On the other hand, when you prevent yourself from engaging in your compulsions, you teach yourself a new way to respond and can experience far less anxiety and frustration with your behaviors over time. 

While it may seem like refraining from compulsions is intolerable, working with a trained specialist in OCD treatment will ensure you’re moving at the right pace and not rushing ahead in your therapy. In my experience as an OCD specialist, I have consistently seen how effective ERP can be for perfectionism OCD, and how the tools people gain through therapy can lead to life-long relief. 

What might this look like for Just Right OCD? You might practice doing something that feels wrong or off to you instead of trying to “fix it” to your liking. If you have a symmetry obsession, for example, you might be guided to arrange the shoes in your closet in a way that isn’t perfectly lined up. Then, instead of rushing to align everything perfectly the moment the anxiety springs up, you’ll learn to sit with the discomfort without giving into the compulsion.

How to Get Help for Just Right/Perfectionism OCD

Often sufferers of Just Right OCD have been engaging in the same obsessions and compulsions since childhood. For this reason, they may come to think of their OCD as part of their personality, or something everyone just does, or something they’ve learned to live with and cannot possibly change. Just Right OCD can impose tremendous challenges for someone’s personal, professional and social life.  Even if these behaviors are something you’ve been doing since childhood, and it seems like there’s no way to overcome them, treatment is available.

It’s not easy to seek treatment, but it truly can make a long-term difference in your life, and effective, personalized treatment is more accessible than ever. 

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